Senior doctors at public hospitals have narrowly voted against asking Te Whatu Ora to pay for their private health insurance.

The vote to include it in a union claim got more than 40 per cent backing from doctors - but not the majority it needed to pass.

Demand for private health cover has been growing across New Zealand as public hospitals struggle more and more.

A Bay of Plenty iwi service recently bought private health insurance for its workers, saying it's "ridiculous" to feel that it had no choice.

Frustration also featured in the recent close vote at the Association of Salaried Medical Specialists.

"There are a number of our members who are worried about access to healthcare through the public system, and that was a slightly unusual expression or indirect expression of that frustration," says association executive director Sarah Dalton.

The vote failed in part because "it doesn't sit comfortably" with the union's mandate to fight for good public healthcare for everyone, she says.

"A number of members pointed out that senior doctors and dentists are probably better equipped given their salaries to provide for themselves in terms of private health insurance, and that is something that a number... do."

Dalton read the debate and vote in another way.

"It wasn't something that we were looking at... it came from the membership," she said of the move at an annual meeting in late 2023.

"It was a way of expressing frustration with Te Whatu Ora as an employer."

Another factor is the high toll that working in health took, from fatigue and burnout.

"The message for us is we need to dig into those issues around health and wellbeing more," says Dalton.

Anyone can bring such a remit but she's not aware if another attempt will be made.

The New Zealand Nurses Organisation says there has been talk among its members about private health insurance.

However, "this has never been put forward as a claim", it says.

The Private Surgical Hospitals Association says it's aware that insurance policy growth over the past few years has been driven by employer schemes.

"Some private health employer entities would offer schemes, but certainly not universally," it says.

"In the private surgical hospital sector, hospitals don't employ doctors, so the model is different than in public."

It has no collective view on whether private health insurance is offered and doesn't collect data on it.

-RNZ.